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Randoms Unit I Ex


Spine fxn protection of spinal canal, structural supports, movement
Herniated disc slipping or weakness of annulus fibrosa and pertrusion of nucleus pulposa
Numbness and weakness are associated with what? Numbness: sensory, weakness: motor
How does smoking ↑ back pain? ↓ blood flow, low regeneration of the interveterbral discs
What nerve is associated w/ loss of B/B fxn L5,S1: loss of muscle tone in pelvic floor
contraction of the sternocleidomastoid muscle suggests torticollis: Lateral deviation and roatation of the head
trendelenburg gait suggests abnl fxn of glut medius in opposite side
Types of curves of lumbar and cervical spine concave
Types of curves of thoracic and sacral spine convex
When is winging of the scapulae seen long thoracic n. palsy: loss of innervation to serratus ant.
Asmmetry of iliac crest suggests leg length discrepancy, or listing to one side: herniated lumbar disc
Tenderness at C1-2 in RA pt’s is a red flag for what subluxation leading to cord compression
1in lateral to the spinious process of c2-c7 facet joints, deep to trapezious, not palpable if muscles aren’t relaxed
Lumbar step off joints suggest suggests spondylolisthesis or fracture
Halfway b/w midline of spine and PSIS of pelvis SI joints
Where is the sciatic notch midway between the greater trochanter of the hip and ischial tuberosity of the pelvis
Tenderness over the sciatic notches suggests impinging on L4,5, S1,2,3 nerve roots
How do we asses the sacrococcygeal joint nl has no movement
What does the straight leg raise test imply 0-30: n. root compression, 30-60: sciatica n. irritation >60: suggests lumbar arthritis or disc dz
Problems w/ hip flexion suggests N. root compression T12, L1,2,3region
Problems/pain with knee extension suggests n root compression at L3 and L4
Weakness w/ ankle dorsiflexion suggests n. root compression of L4,L5
Great toe extension pain/problems suggests L5 compressions
Plantar flexion power aka toe raises difficult means s1
Strength testing 3: gravity, 4: some resistance 5: nl resistance 2: minus gravity 1: muscle contraction w/ limited motion
What does CMS stand for circultation, motor, sensory
Four joints of the shoulder AC GH SC Scapular thoracic
What are the functional ligaments of the shoulder? Glenohumeral ligaments
Function of the rotator cuff keep humeral head within joint, abducts, externally and internally rotates
How can we determine b/w tendonitis vs RCT? strength test, can still do it w/ tendonitis, just hurts
Resisted external rotation tests infraspinatus and teres minor
Internal rotation tests subscapularis
Emplty can tests what supraspinatus
Lift off tests what subscapularis
How can we test for a supraspinatus tear? abduct arm w/ elbow straight up, bring down to 90degress and let go, if pt’s arm drops and can’t hold it up
XR signs of a RCT high riding humerous
What pain is worse at night, outer deltoid pain, especially when reaching over head impingement syndrome
Signs of impingment syndrome neer’s impingment, abduction, Hawkins
Two signs of shoulder instability apprehension test and the sulcus when pressure is applied
Do pt’s get weakness in the arm w/ a biceps tendon tear? not always because have the brachialis and brachioradialis for other flexors
Pelvis is formed by fusion of what pubis, ileum, and ischium
Hip abductors and adductors gluteus medius and minimus,, adductor brevis longus and magnus
Site of pain, radiation, and aggravators for Hip joint pain Ant, groin, wide, joint movement
Site of pain, radiation, and aggravators for n. root L1/L2 herniation Groin and back, leg, straining
What do we palpate for in the femoral grove nerve, artery, vein, empty space, lymph node (NAVEL)
How do we measure true leg length ASIS to inferior border of medial malleolus
Used to detect a fixed flexion deformity of the hip Thomas’ test
Deep boring pain in the gluteal region Trochanteric bursitis, either truma or pressure or OA
Hindfoot, midfoot, forefoot H: talus and calcaneus M: navicular, cuboid, 3 cuneiforms, F: metatarsals and phalanges
Severe inversion of ankle injury often when jumping, pain w/ wt bearing Jones fracture
Mc age for achillie tendon rupture 40yo, feel like being hit w/ a bat
First step feels like stepping on a pin, improves w/ heat and activity plantar fasciitis
In MN where is gout commonly seen men and hmong
MOI is longitudinal injury to foot landing on toes Lisfranc joint injury
Tests for ankle stability talar tilt test: lateral ligament stability, anterior drawer test
Test for the syndesmosis widened or displaced mortise joint of the ankle
Test for Achilles tendon rupture Thompson test: if rupture still may have some movement: COMPARE L & R
Lisfranc injury injury to the tarsal metatarsal joint d/t landing on toes
What position is it easier to give knee injections flexed
Pain that gets worse in the eve or during/after exercise, improves w/ rest suggests intra-articular pathology
Pain when going up/down stairs or aching in positions when kept flexed for long periods of time suggests patellar or patelofemoral problems
Pain that occurs when the knee is hyperflexed and pain w/ twisting suggests meniscal pathology
Is popping or clicking of the knee nl? Locking? yes, and no: meniscal injury
Pain w/ weight bearing suggests tibial plateau frx or other intra-articular injury
How do meniscal injuries occur twisting or declaration
What is the terrible triad ACl, MCL and medial meniscus tear
Concern w/ dislocation/subluxation of the patella? injury to the popliteal artery
Where do patellar, quad, and IT tract tendonitis present pain Distal to knee, prox. To patella, and lateral leg along tensor fascia lata
Non contact injury w/ a pop most likely ACL tear d/t hyperextension
Contact injury w/ a pop ACL, PCL, meniscal tears or a fracture
Acute swelling of knee could suggest ACL, PCL tears, frx, patellar dislocation, knee dislocation ant or post
Knock-kneed, bow-legged Genu Valgum, Genu Verum
J sign as knee goes from extension to flexion, the patella tracks sup and lat d/t too strong of quads: vastas lateralis
Buldge sign for mild effusions, “milk” the fluid down place pressure over medial joint line and tap on lat:fluid wave
What is the Balloon sign for lg effusions, 1 hand sup and 1 hand inf to patella, or just tappin on joint sends fluid save
Balloting the patella for lg effusions, compress suprapatellar pouch w/ one hand and patella w/ the other, + if fuild felt being forced into suprapatellar pouch when patella is compressed
Two tests for ACL assessment Anterior Drawer test, Lachman’s test
Tests for PCL injury Post drawer test, Sag sign
Two tests for meniscus evaluation apley’s grind test: prone, McMurry’s test: supine
Difference b/w weakness and general fatigue weakness: muscular, fatigue:to tired to do anything
Proximal vs. distal weakness P: myopathy, D: neuropathy
Order of the ortho PE Insepection, Palpation, ROM, Muscle testing, CMS, special tests
Through all PROM no pain usually extra-articular, w/ pain w/ PROM: intra-articular
Fracture through one cortex greenstick fx
MOI is shearing/twisting motion oblique frx
Buckling of the cortex torus frx
Salter-Harris SALTR: I: physicis, II: metaphysis, III: epi, IV: both epi and meta, V: crush to physis
What will plain films show frxs, joint effusions, joint crystals, arthritis, ST swelling and foreign bodies
Good for soft tissues like ligaments and cartilage MRI scan
How do we describe a fracture e Location, Direction of line (transvers/oblique), Relationship of fragments(displacement, angulation, shortening, rotation) # of fragments (simple/comminuted) Communication w/ atmosphere
Are plain films the study of choice for osteoporosis/osteopenia no d/t variation in XR technique
Nerves to the sensory of the hand Radial: dorsum only, ulnar: 4th and 5th digit, median: palmer
Two point discrimination should be how mm apart 6mm
Smoking can cause what in the hand raynaud’s phenomenon
What can psoriasis show up as in the hands nail deformities eg. Pitting, and psoriatic arthropathies
Name the flexors and extensors of the thumb EPL, EPB, and FPL
What joints to OA and RA commonly affect OA: DIP and PIP RA: MC and wrist
Two signs for CTS Phalen’s and Tinnel’s and Scratch and n. compression test
Two tests for ulnar nerve conmpression Pope’s blessing and fromenents signs
Palpation over the MP joint w/movement of finger causes clunking and cracking Trigger finger of extensor
Test for thumb arthritis CMC grind test, axial force on thumb and grind 180 degrees: pain and clunking
What should we asses in a finger lac digital n. sensation PRIOR to anesthesia
90% of spinal inturies are d/t what? MC area? blunt force trauma, Cervical MC
When do we immobilize the C-spine in a trauma after ABC’s and life has been assessed
Two studies done on clinical c spine clearance nat’l emergency XR utilization study (NEXUS) and Canadian C-spine study
Nexus criteria 1: no post midline cervical tenderness 2: nl level of alertness 3: no focal neuro deficits 4: no painful distracting injuries 5: no evedince of intoxication
Canadian C Spine rules fall from 3ft or 5stairs, axial load to head/spine, MVA at high speed >100km/hr or rollover/ejection, bicycle collision, colisions w/ motorized recreational vehicle
Which criteria is better for cspine clearance Canadian Cspine rule
Name three primary methods of cervical spine imaging plain films, ct and mri: no really used
Three views for c spine lateral, opontoid, ap lat: 70-80% detection
What is the AP view used for to examine angulation of lateral cortex of articular masses as compared w/ superior or inferior neighbors
Lateral xr should include what C1-T`1, and four lines of the spine: Ant and Post longitudinal ligament line, spino-laminal line, spinous process line
What is the pre dental space distance between posterior aspect of anterior arch of C1 and anterior aspect of odontoid process normally no more than 3 mm in adults and 5 mm in children
What measurement of swelling of the preveterbral space indicates a fracture at C2: >7mm, at C6 >21mm
Angulation of more than what indicates abnormalities between the intervertebral spaces 11 degrees
What would indicate ligament disruption on a plain film for a lateral c spine fanning of the spinous processes
How do we evaluate the odontoid location odontoid view, dens centered bw lat masses of C1, lat masses of C1 should be directly over lat portions of c2,
How do we check for rotation of the head in an odontoid view the dens is inline with the central incisors
What are the three types of odointoid frxs I: avulstion, II: “neck” frx III: through the body of C1
Functions and uses of a MRI all pts w/ neuro deficits d/t spinal cord injury, evaluations of epidural space, herniated discs, hematomas and bone fragments,
Four flexion injuries of the c spine flexion teardrop fx, clay-shoverler’s fx, wedge compression fx, bilateral interfacetal dislocation
Flexion-rotation injury unilateral interfacetal dislocation
Hyperextension injuries extension teardrop fx, hangman’s fx
Vertical compression injury jefferson’s fx
Medical specialty devoted to prevention and management of occupational and environmental injury, illness, and disability Occupational and environmental medicine
Temporary flareup of something related to a pre-existing condition (asthma) usually after an injury but recedes to former leven w/I a reasonable period of time exacerbation
Fresh incident producing additional impairment to a previously injured anatomical region Aggravation: usually not temporary: the arthritic employee
Anatomically or physically wrong with an individual and is a means where the medical care provider assigns a numerical rating for whatever type of bodily fxn has been lost impairment: a % of impairment, can be permanent or temporary
Impairment combined w/ person’s age, ed background, other factor affect an injured workers ability to work Disability
Impairment that can be overcome by some type of reasonable accommodation to the impairment Handicapped
Injured workers are only able to do some type of limited work for a short period of time and that further recovery is expected Temporary partial disability: most work related injuries
Person is unable to do any type of work for a temporary period of time Temporary total disability Work Comp usually paid while injured worker is out of work: BE CAREFUL to hand these out
Injured worker cannot return to same type of work he was doing prior to injury and lost his ability to do the prior work permanent partial disability: loss of a finger
Injured worker is unable to do any type of work of any kind and person is completely and permanently incapable of engaging in a type of substantial gainful activities permanent total disability: loss of vision
Law that allows employees at least 12m LOA FMLA Family and Medical Leave Act
Characteristics of FMLA non-compensatory, JOB PROTECTION, when return, nomore than 12 wks/12m
Ensuring the candidate is qualified to perform essential fxns of the job prior to formal consideration for the position pre-employment exam
Conducted after employee has been formally interviewed and is being considered for the position: also w/ a different role pre-placement exam
The exam for occupations w/ significant risk of self or public injury periodic exams: Aviation, DOT
A tool to ensure the employee is able to return after extended absence, usually from a medically leave Fitness for duty
The injured employee has recovered to where no further recovery will happen maximum medical improvement
Gap b/w their improvement and 100% permanent partial disability
Specific modifications that are communicated form clinician to employer accommodations
An employer is either obligated to accommodate per the clinicians modifications or send the employee home Law of reasonable accommodation: a federal law
Work comp payment amount 85% of employees pay w/o taxes
Written statement by the clinician given to the employee/and employer noting clinician dx, limitations, and work assessment Report of workability
How long are work comp cases open? 130wks or 910 days will get moved to perm partial disability
Created by: streetsmarts